孤残儿童龋齿患病状况及影响因素的系统评价和 Meta 分析
Caries in orphan children: prevalence and determinants-a systematic review and meta-analysis.
机构信息
Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Ahram Canadian University, 4th Industrial Zone, Banks Complex, 6th of October City, Giza, Egypt.
Pediatric and Community Dentistry Department, Ahram Canadian University, 6th of October City, Giza, Egypt.
出版信息
BMC Oral Health. 2024 Mar 25;24(1):381. doi: 10.1186/s12903-024-04125-9.
BACKGROUND
Orphan children represent a category of children who lost their family support. Their health status is poorer when compared to their parented counterparts. As the most prevalent disease in the world, dental caries is expected to affect orphans greatly. Being vulnerable, health status of orphan children must be monitored and studied; so that health improvement plans would be formulated. Therefore, this systematic review focuses on the extent of the dental caries problem among institutionalized orphan children and its determinants.
METHODS
The review has two outcomes: comparing caries experience of institutionalized children to their parented counterparts, and reviewing the determinants of caries in the exposure group. Two systematic searches (one for each outcome) were run on MedLine via PubMed, Cochrane library, LILACS, Egyptian knowledge bank (EKB) and Google Scholar; beside hand search and searching grey literature.
RESULTS
The searches yielded 17,760, followed by 16,242 records for the first and second outcomes respectively. The full text was screened for 33 and 103 records for the two outcomes respectively; after translating non-English reports. Finally, the review included 9 records to address the first outcome and 21 records for the second. The pooled results showed that the exposure group may show slightly poorer caries experience regarding permanent teeth (pooled mean difference of DMF = 0.09 (-0.36, 0.55)); but they have a much poorer caries experience regarding primary teeth health (pooled mean difference of dmf = (0.64 (-0.74, 2.01)). Meta-analysis of the caries determinants showed that institutionalization increases the risk of caries by 19%. Gender showed slight effect on caries risk with males being more affected; while primary teeth revealed higher risk of caries when compared to permanent teeth.
CONCLUSION
Limited by the heterogeneity and risk of bias of the included studies, meta-analyses concluded that institutionalized orphan children have higher risk of caries. Yet, the institutionalization circumstances were not well-documented in all the included studies. So, the complete picture of the children's condition was not possibly sketched.
TRIAL REGISTRATION
Protocol has been registered online on the PROSPERO database with an ID CRD42023443582 on 24/07/2023.
背景
孤儿是失去家庭支持的一类儿童。与有父母的儿童相比，他们的健康状况较差。龋齿是世界上最普遍的疾病，预计会对孤儿产生很大的影响。由于孤儿较为脆弱，必须对其健康状况进行监测和研究，以便制定改善健康的计划。因此，本系统评价重点关注机构内孤儿的龋齿问题的严重程度及其决定因素。
方法
本研究有两个结果：比较机构内儿童与有父母的儿童的龋齿患病情况，以及回顾暴露组中龋齿的决定因素。通过 MedLine 上的 PubMed、Cochrane 图书馆、LILACS、埃及知识库（EKB）和 Google Scholar 进行了两次系统搜索（每个结果一次）；此外，还进行了手工搜索和灰色文献搜索。
结果
第一次搜索得到了 17760 条记录，第二次搜索得到了 16242 条记录。对 33 篇和 103 篇文献的全文进行了筛选，以分别解决两个结果。最后，该评价纳入了 9 篇文献来解决第一个结果，纳入了 21 篇文献来解决第二个结果。汇总结果表明，与恒牙相比，暴露组的儿童可能有稍差的龋齿患病情况（DMF 的汇总平均差异为 0.09（-0.36，0.55））；但他们的乳牙健康状况更差（dmf 的汇总平均差异为 0.64（-0.74，2.01））。龋齿决定因素的荟萃分析表明，机构化使龋齿的风险增加了 19%。性别对龋齿风险有轻微影响，男性受影响更大；而与恒牙相比，乳牙的龋齿风险更高。
结论
由于纳入研究的异质性和偏倚风险的限制，荟萃分析得出结论，机构化的孤儿患龋齿的风险更高。然而，并非所有纳入的研究都详细记录了机构化的情况。因此，可能无法全面描绘儿童的状况。
试验注册
本方案于 2023 年 7 月 24 日在 PROSPERO 数据库中以 ID CRD42023443582 在线注册。
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